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Snags for overdose-reversing drug in Utah

SALT LAKE CITY — A widely available antidote has reversed more than 1,800 painkiller and heroin overdoses in Utah, but advocates say stigma around syringes has stymied its success.

Authorities and others are confiscating needles that come packaged with naloxone under the suspicion that they are drug paraphernalia, say those who provide the kits. It’s happening on sidewalks, in treatment centers and workplaces across the state, even though the substance and accompanying needles are legal.

“If you have the two little vials, you can’t eat it. You can’t break it open and sprinkle it in your eye. You have to have a syringe,” said Jennifer Plumb, medical director of Utah Naloxone. “Much like if a diabetic needs syringes, it’s part of a medical-attention strategy.”

The reason behind the apparent trend isn't clear, but it raises alarm as opiate addiction claims more lives in Utah and around the country.

It's possible that someone could use naloxone needles to instead inject illicit drugs, but that risk is not worth taking away an opportunity to save someone's life, say some state leaders.

“This kit isn’t a drug-paraphernalia kit,” Utah Attorney General Sean Reyes said at the November meeting of the state's Opioid Task Force, which includes doctors, sheriffs, lawmakers and others. “This kit is a lifesaving kit that we need to make sure we get into the hands of as many people as possible.”

Also known by its brand name Narcan, the drug can be injected or sprayed up the nose, allowing overdose victims to narrowly escape death and breathe again within minutes.

The nasal spray's $150 price tag often is too steep for those buying it on their own, and some insurance companies won't cover it. The injectable kit is more common and runs about $50.

The Utah Legislature has approved the antidote, and police officers who carry it “have been our biggest champion,” Plumb said.

The Utah Department of Health has made a public relations push and distributed nearly 2,000 kits paid for by the state. But reports of confiscations are on the rise.

The trend did not surprise Tom Ross, president of the Utah Chiefs of Police Association, who notes that officers have long been directed to seize syringes.

"When an officer's doing a drug investigation, they're collecting needles. Sometimes it may not be clearly understood — what is treatment and what is drug abuse or use," said Ross, the chief of police in Bountiful.

His association colleagues had a different reaction when he raised the issue at their conference in November.

"The chiefs were just looking back and forth at each other, shocked that this was a problem," Ross said. They returned and discussed the issue with their officers, he added.

"I think we recognize in law enforcement that the opioid crisis is real and it's significant, and if there are things we can do to help save lives, we're absolutely interested in doing that," Ross said.

Advocates say it's not clear why confiscations have risen even as more departments have signed on to carry the drug.

Needle exchanges, which seek to prevent the spread of hepatitis C and other disease by providing clean syringes to those injecting drugs may have inadvertently “revved up needle phobia,” Plumb said.

Utah Naloxone also has ramped up its distribution, so sheer prevalence of the antidote may play a part. Of more than 13,000 kits passed out to Utahns over the past two years, at least 3,000 went out in September, October and November.

Up until fall, Plumb had heard sporadic complaints of seized naloxone needles. But since then, complaints have risen, she said, culminating in late October with a 48-hour period when five people told her separately that they or a family member had to give up a needle from the kit.

Patrick Rezac, executive director of One Voice Recovery, said he has seen a similar trend. Reports to his group rose in October, up to a high of four in a day, though the incidents didn't all occur within the same 24-hour period.

It’s “a small percentage” of encounters with authorities and administrators that lead to a seizure, he said, “but enough to be alarmed.”

“It just feels like a punitive, sort of targeted response” toward drug users, Rezac said. “There’s no other reason to take a lifesaving tool from somebody.”

Rezac and Plumb declined to call out specific agencies or groups. They said the issue is not confined to law enforcement, but also has cropped up at job environments and in housing and treatment.

In 2015, Dennis Cecchini's adult son overdosed on heroin in the shower and died after a long battle with painkiller addiction and several stints in treatment. Cecchini hadn’t known about the drug until after he buried his son, he said.

“It’s an abomination” that some have seized the anti-overdose agent from those who carry it, Cecchini said. “This is not how we’re going to save lives."

Rep. Carol Spackman Moss, who sponsored the law allowing police and others to obtain the antidote without a prescription, then to administer it to an overdose victim without facing drug charges or liability, is not planning to bring any legislation to clarify that naloxone is legal, she said, because the existing code already does that.

Still, personal experience has taught the Holladay Democrat that awareness has not always kept pace with updates to Utah code.

Moss encountered a Murray police officer in fall 2015, she said, and asked if he carried the antidote. He did not, he replied, because he didn’t want to face a lawsuit for injecting it.

“I said, 'That's the point of my law,” she said. “If you can save a life, you might get them into treatment."

All Murray Police Department officers now carry naloxone.